Alcohol ingestion impairs maximal post-exercise rates of myofibrillar protein synthesis following a single bout of concurrent training

Enhancing satiety and aerobic performance with beer microparticles-based non-alcoholic drinks: exploring dose and duration effects

Beer is an alcoholic beverage, rich in carbohydrates, amino acids, vitamins and polyphenols, consumed worldwide as a social drink. There is a large number of beer styles which depends on the ingredients and brewing process. The consumption of beer as a fluid replacement after sport practice is a current discussion in literature. A non-alcoholic pale-ale microparticles-based beverage (PABM) have been previously designed, however, its phenolic profile and ergogenic effect remain unknown. Thus, this study aims to verify the ergogenic potential (increase of running performance) of PAMB in male Wistar rats. Beer microparticles were obtained by spray drying and beverages with different concentrations were prepared in water. Wistar rats were subjected to a training protocol on a treadmill (5 times/week, 60 min/day) and daily intake of PABM (20 mg.kg-1 or 200 mg.kg-1) or water by gavage. Chlorogenic acid was found to be the main component in the phenolic profile (12.28 mg·g-1) of PABM analyzed with high-performance liquid chromatography and mass spectrometry. An increase in the aerobic performance was observed after 4 weeks in the 20 mg.kg-1 group, but the same dose after 8 weeks and a higher dose (200 mg.kg-1) blunted this effect. A higher dose was also related to decrease in food intake. These data suggest that PABM can improve satiety and aerobic performance, but its effect depends on the dose and time of consumption.

Time Course of Proteolysis Biomarker Responses to Resistance, High-Intensity Interval, and Concurrent Exercise Bouts

ABSTRACT

Godwin, JS, Telles, GD, Vechin, FC, Conceição, MS, Ugrinowitsch, C, Roberts, MD, and Libardi, CA. Time course of proteolysis biomarker responses to resistance, high-intensity interval, and concurrent exercise bouts. J Strength Cond Res 37(12): 2326-2332, 2023-Concurrent exercise (CE) combines resistance exercise (RE) and high-intensity interval exercise (HIIE) in the same training routine, eliciting hypertrophy, strength, and cardiovascular benefits over time. Some studies suggest that CE training may hamper muscle hypertrophy and strength adaptations compared with RE training alone. However, the underlying mechanisms related to protein breakdown are not well understood. The purpose of this study was to examine how a bout of RE, HIIE, or CE affected ubiquitin-proteasome and calpain activity and the expression of a few associated genes, markers of skeletal muscle proteolysis. Nine untrained male subjects completed 1 bout of RE (4 sets of 8-12 reps), HIIE (12 × 1 minute sprints at V̇ o2 peak minimum velocity), and CE (RE followed by HIIE), in a crossover design, separated by 1-week washout periods. Muscle biopsies were obtained from the vastus lateralis before (Pre), immediately post, 4 hours (4 hours), and 8 hours (8 hours) after exercise. FBXO32 mRNA expression increased immediately after exercise (main time effect; p < 0.05), and RE and CE presented significant overall values compared with HIIE ( p < 0.05). There was a marginal time effect for calpain-2 mRNA expression ( p < 0.05), with no differences between time points ( p > 0.05). No significant changes occurred in TRIM63/MuRF-1 and FOXO3 mRNA expression, or 20S proteasome or calpain activities ( p > 0.05). In conclusion, our findings suggest that 1 bout of CE does not promote greater changes in markers of skeletal muscle proteolysis compared with 1 bout of RE or HIIE.

Alcohol and Skeletal Muscle in Health and Disease

PURPOSE

Alcohol-related myopathy is one of the earliest alcohol-associated pathological tissue changes that is progressively exacerbated by cumulative long-term alcohol misuse. Acute and chronic alcohol use leads to changes in skeletal muscle mass and function. As discussed in this evidence-based review, alcohol-mediated mechanisms are multifactorial with effects on anabolic and catabolic signaling, mitochondrial bioenergetics, extracellular matrix remodeling, and epigenomic alterations. However, systematic studies are limited, especially regarding the acute effects of alcohol on skeletal muscle.

SEARCH METHODS

This review focuses on peer-reviewed manuscripts published between January 2012 and November 2022 using the search terms "alcohol" or "ethanol" and "skeletal muscle" in MEDLINE, PubMed, and Web of Science using EndNote reference management software.

SEARCH RESULTS

Eligible manuscripts included full-length research papers that discussed acute and chronic effects of alcohol on skeletal muscle mass and function in both clinical and preclinical studies. The review also includes alcohol-mediated skeletal muscle effects in the context of comorbidities. The three databases together yielded 708 manuscripts. Of these, the authors excluded from this review 548 papers that did not have "alcohol" or "muscle" in the title and 64 papers that were duplicates or did not discuss skeletal muscle. Thus, of all the manuscripts considered for this review, 96 are included and 612 are excluded. Additionally, relevant papers published earlier than 2012 are included to provide context to the review.

DISCUSSION AND CONCLUSIONS

Both acute and chronic alcohol use decrease protein synthesis and increase protein degradation. Alcohol also impairs mitochondrial function and extracellular matrix remodeling. However, there is a gap in the literature on the known alcohol-mediated mechanisms, including senescence, role of immune activation, and interorgan communication, on the development of alcohol-related myopathy. With increased life expectancy, changing alcohol use patterns, and increasing frequency of alcohol use among females, current observational studies are needed on the prevalence of alcohol-related myopathy. Additionally, the compounding effects of acute and chronic alcohol use on skeletal muscle with aging or exercise, in response to injury or disuse, and in the context of comorbidities including diabetes and human immunodeficiency virus (HIV), call for further investigation. Though evidence suggests that abstinence or reducing alcohol use can improve muscle mass and function, they are not restored to normal levels. Hence, understanding the pathophysiological mechanisms can help in the design of therapeutic strategies to improve skeletal muscle health.

Investigation of supplement use and knowledge among Japanese elite athletes for the Tokyo 2020 Olympic/Paralympic games and the Beijing 2022 winter Olympic/Paralympic games

Elite athletes frequently invest in the use of supplements to optimize their dietary regimens and enhance their athletic performance. However, unregulated and unplanned use of supplements can lead to adverse consequences, including anti-doping rule violations or health issues. Thus, athletes should verify their diets, consider scientific evidence, and take necessary precautions regarding supplements before use. To date, no study has explored whether athletes check these factors before using supplements. This study aimed to investigate supplement use using a questionnaire administered to 1,392 athletes (including candidate athletes) who participated in the Tokyo 2020 Olympic/Paralympic and Beijing 2022 Winter Olympic/Paralympic Games. Participants were categorized as follows: 1,040 participants in the Tokyo 2020 Olympic Games, 83 in the Tokyo 2020 Paralympic Games, 239 in the Beijing 2022 Winter Olympic Games, and 30 in the Beijing 2022 Winter Paralympic Games. We collected data on supplement use and gained further knowledge through interviews with the athletes. Approximately 70% of Tokyo 2020 Olympic/Paralympic and Beijing 2022 Winter Olympic athletes and approximately 50% of Beijing 2022 Winter Paralympians used supplements. Over 50% of athletes had not received a doctor's diagnosis or a dietitian's evaluation before supplement use. Moreover, only 50% of the athletes who used dietary supplements reviewed the scientific evidence for the dietary supplements before using them and justified their choice based on their own investigation, while those who did not use dietary supplements cited either a lack of need or fear of an anti-doping rule violation. Considering the holistic health and performance of athletes, as well as the risk associated with unregulated use, such as overdose and anti-doping rule violations, there is a need for nutritional education on supplement use for athletes and their entourages.

Excessive Ethanol Intake in Mice Does Not Impair Recovery of Torque after Repeated Bouts of Eccentric Contractions

PURPOSE

Alcoholics develop muscle atrophy and weakness from excessive ethanol (EtOH) intake. To date, most research has examined outcomes of alcohol-induced atrophy and weakness under basal or unstressed conditions despite physical stress being a normal occurrence in a physiological setting. Therefore, this study set out to determine if recovery of torque is impaired after repetitive bouts of physical stress in skeletal muscle during excessive short-term (experiment 1) and long-term (experiment 2) EtOH consumption.

METHODS

Twenty male and female mice were assigned to receive either 20% EtOH in their drinking water or 100% water. Short- and long-term consumption was predetermined to be EtOH intake starting at 4 and 26 wk, respectively. Anterior crural muscles performed repeated bouts of physical stress using in vivo eccentric contractions, with tetanic isometric torque being measured immediately pre- and postinjury. A total of 10 bouts were completed with 14 d between each bout within bouts 1-5 (experiment 1) and bouts 6-10 (experiment 2), and 12 wk between bouts 5 and 6.

RESULTS

Mice consuming EtOH had blood alcohol concentrations up to 270 mg·dL -1 . In experiment 1, five bouts of eccentric contractions did not reduce recovery of torque, regardless of sex or EtOH treatment ( P ≥ 0.173). Similarly, in experiment 2, preinjury torques did not differ from day 14 values regardless of sex or treatment ( P ≥ 0.322). However, there was a group effect in female mice for bouts 6 and 10 during experiment 2, with female EtOH mice being weaker than controls ( P ≤ 0.002).

CONCLUSIONS

Excessive short- or long-term EtOH misuse in a mouse model did not affect the muscle's ability to regain strength after repeated bouts of eccentric contractions, suggesting that EtOH may not be as detrimental to recovery as once predicted.

Alcohol, Resistance Exercise, and mTOR Pathway Signaling: An Evidence-Based Narrative Review

Skeletal muscle mass is determined by the balance between muscle protein synthesis (MPS) and degradation. Several intracellular signaling pathways control this balance, including mammalian/mechanistic target of rapamycin (mTOR) complex 1 (C1). Activation of this pathway in skeletal muscle is controlled, in part, by nutrition (e.g., amino acids and alcohol) and exercise (e.g., resistance exercise (RE)). Acute and chronic alcohol use can result in myopathy, and evidence points to altered mTORC1 signaling as a contributing factor. Moreover, individuals who regularly perform RE or vigorous aerobic exercise are more likely to use alcohol frequently and in larger quantities. Therefore, alcohol may antagonize beneficial exercise-induced increases in mTORC1 pathway signaling. The purpose of this review is to synthesize up-to-date evidence regarding mTORC1 pathway signaling and the independent and combined effects of acute alcohol and RE on activation of the mTORC1 pathway. Overall, acute alcohol impairs and RE activates mTORC1 pathway signaling; however, effects vary by model, sex, feeding, training status, quantity, etc., such that anabolic stimuli may partially rescue the alcohol-mediated pathway inhibition. Likewise, the impact of alcohol on RE-induced mTORC1 pathway signaling appears dependent on several factors including nutrition and sex, although many questions remain unanswered. Accordingly, we identify gaps in the literature that remain to be elucidated to fully understand the independent and combined impacts of alcohol and RE on mTORC1 pathway signaling.

Understanding the role of smoking and chronic excess alcohol consumption on reduced caloric intake and the development of sarcopenia

This narrative review provides mechanistic insight into the biological link between smoking and/or chronic excess alcohol consumption, and increased risk of developing sarcopenia. Although the combination of excessive alcohol consumption and smoking is often associated with ectopic adipose deposition, this review is focused on the context of a reduced caloric intake (leading to energy deficit) that also may ensue due to either lifestyle habit. Smoking is a primary cause of periodontitis and chronic obstructive pulmonary disease that both induce swallowing difficulties, inhibit taste and mastication, and are associated with increased risk of muscle atrophy and mitochondrial dysfunction. Smoking may contribute to physical inactivity, energy deficit via reduced caloric intake, and increased systemic inflammation, all of which are factors known to suppress muscle protein synthesis rates. Moreover, chronic excess alcohol consumption may result in gut microbiota dysbiosis and autophagy-induced hyperammonemia, initiating the up-regulation of muscle protein breakdown and down-regulation of muscle protein synthesis via activation of myostatin, AMPK and REDD1, and deactivation of IGF-1. Future research is warranted to explore the link between oral healthcare management and personalised nutrition counselling in light of potential detrimental consequences of chronic smoking on musculoskeletal health outcomes in older adults. Experimental studies should investigate the impact of smoking and chronic excess alcohol consumption on the gut-brain axis, and explore biomarkers of smoking-induced oral disease progression. The implementation of behavioural change interventions and health policies regarding smoking and alcohol intake habits may mitigate the clinical and financial burden of sarcopenia on the healthcare system.

A Single Dose of Beer after Moderate Aerobic Exercise Did Not Affect the Cardiorespiratory and Autonomic Recovery in Young Men and Women: A Crossover, Randomized and Controlled Trial

Background: Beer is a choice beverage worldwide and is often consumed after sports for social interaction. Beer has been suggested for hydration after exercise, but the effects on cardiovascular and autonomic systems in men and women after effort are unknown. Objectives: We assessed the effect of beer absorption immediately after moderate exercise on heart rate (HR) variability (HRV) and cardiovascular recovery after effort in women and men separately. Methods: This is a crossover, randomized and controlled trial performed on 15 healthy female and 17 male adults submitted to two protocols on two randomized days: (1) Water (350 mL) and (2) Beer (350 mL). The subjects underwent 15 minutes seated at rest, followed by aerobic exercise on a treadmill (five minutes at 50-55% of maximum HR and 25 min 60-65% of maximum HR) and then remained 3 min stood on treadmill and 57 min seated for recovery from the exercise. Water or beer was consumed between four and ten minutes after exercise cessation. Blood pressure, HR and HRV were evaluated before exercise, during exercise and during recovery from exercise. Results: Systolic and diastolic blood pressure, HRV and HR changes during and following recovery from exercise were similar when women consumed beer or water. HR, systolic and diastolic blood pressures also returned to baseline levels in the beer and water protocols in males. Yet, parasympathetic indices of HRV recovery from exercise were comparable between protocols in males. Conclusions: Ingestion of 300 mL of beer did not significantly affect HRV and cardiovascular parameters following effort. Our data indicate that beer was safe for this population.

Impact of Eating Speed on Muscle Mass in Older Patients With Type 2 Diabetes: A Prospective Study of KAMOGAWA–DM Cohort

Background and Aims

Maintenance of muscle mass is important for sarcopenia prevention. However, the effect of eating speed, especially fast, normal, or slow speed, on muscle mass changes remains unclear. Therefore, the purpose of this prospective study was to investigate the effect of eating speed on muscle mass changes in patients with type 2 diabetes (T2DM).

Methods

This study included 284 patients with T2DM. Based on a self–reported questionnaire, participants were classified into three groups: fast–, normal–, and slow–speed eating. Muscle mass was assessed using a multifrequency impedance body composition analyzer, and skeletal muscle mass (SMI) decrease (kg/m²/year) was defined as [baseline SMI (kg/m²)–follow–up SMI (kg/m²)] ÷ follow–up duration (year). The rate of SMI decrease (%) was defined as [SMI decrease (kg/m²/year) ÷ baseline SMI (kg/m²)] × 100.

Results

The proportions of patients with fast–, normal–, and slow–speed eating were, respectively, 50.5%, 42.9%, and 6.6% among those aged <65 years and 40.4%, 38.3%, and 21.3% among those aged ≥65 years. In patients aged ≥65 years, the rate of SMI decrease in the normal (0.85 [95% confidence interval, CI: −0.66 to 2.35]) and slow (0.93 [95% CI −0.61 to 2.46]) speed eating groups was higher than that in the fast speed eating group (−1.08 [95% CI −2.52 to 0.36]). On the contrary, there was no difference in the rate of SMI decrease among the groups in patients aged <65 years. Compared with slow speed eating, the adjusted odds ratios of incident muscle loss [defined as rate of SMI decrease (%) ≥0.5%] due to fast– and normal–speed eating were 0.42 (95% CI 0.18 to 0.98) and 0.82 (95% CI 0.36 to 2.03), respectively.

Conclusion

Slow–speed eating is associated with a higher risk of muscle mass loss in older patients with T2DM.

Evidence‐Based Recovery in Soccer – Low‐Effort Approaches for Practitioners

Strategies to improve recovery are widely used among soccer players at both amateur and professional levels. Sometimes, however, recovery strategies are ineffective, improperly timed or even harmful to players. This highlights the need to educate practitioners and athletes about the scientific evidence of recovery strategies as well as to provide practical approaches to address this issue. Therefore, recent surveys among soccer athletes and practitioners were reviewed to identify the recovery modalities currently in use. Each strategy was then outlined with its rationale, its physiological mechanisms and the scientific evidence followed by practical approaches to implement the modality. For each intervention, practical and particularly low-effort strategies are provided to ensure that practitioners at all levels are able to implement them. We identified numerous interventions regularly used in soccer, i.e., sleep, rehydration, nutrition, psychological recovery, active recovery, foam-rolling/massage, stretching, cold-water immersion, and compression garments. Nutrition and rehydration were classified with the best evidence, while cold-water immersion, compression garments, foam-rolling/massage and sleep were rated with moderate evidence to enhance recovery. The remaining strategies (active recovery, psychological recovery, stretching) should be applied on an individual basis due to weak evidence observed. Finally, a guide is provided, helping practitioners to decide which intervention to implement. Here, practitioners should rely on the evidence, but also on their own experience and preference of the players.

Dietary Intakes, Knowledge, and Perceptions of Semi-professional Rugby Athletes in Scotland

Background

Adequate nutritional intake plays a pivotal role in optimizing performance, recovery, and body composition goals. This study aimed to investigate the dietary intakes (DIs); nutritional knowledge (NK); and attitudes, perceptions, and challenges (APC) of semiprofessional rugby players in Scotland.

Methods

Dietary intakes and NK of 24 male semiprofessional rugby players of a Super6 club were evaluated using validated questionnaires. Players were categorized as having good or poor NK according to NK scores. Diet-related APCs were assessed using researcher-developed questionnaires and 1-1 semi-structured interviews.

Results

Mean ± SD total NK% was poor, 53.7 ± 11.9%. The ‘Good’ NK group scored significantly higher in the Weight Management (p = 0.014), Macronutrients (p < 0.001), Micronutrients (p = 0.001), and Sports Nutrition (p < 0.001) sections. Mean DIs from food sources were 26.3 ± 9.2 kcal/kg/day energy, 1.4 ± 0.4 g/kg/day protein, and 21.7 ± 10.1 g/day fibre. Median (25th,75th) carbohydrate intake was 3.0 (2.0, 3.0) g/kg/day, and 6.3 (2.3, 10.6) units/week alcohol. Mean ± SD fat and saturated fat (SFA) % total energy intake (EI) were 36.2 ± 3.7% and 12.8 ± 1.9%, respectively, and SFA %EI exceeded recommendations (p < 0.001). The ‘Good’ NK group had significantly higher intakes of all macronutrients (p < 0.05). Total NK% positively correlated with intakes of meat (r = 0.556, p = 0.011), cereals (r = 0.458, p = 0.042), dietary fat (r = 0.477, p = 0.034), vegetables (r = 0.487, p = 0.030), and alcoholic beverages (r = 0.541, p = 0.014). Supplement use was 68%. Players felt diet affected performance (94%) but 31% of them were unaware of any specific nutritional strategies. A healthy diet was perceived to be ‘balanced’ with ‘variety from all food groups. Lack of time for preparation was described as the main barrier to healthy eating.

Conclusions

Overall, players had poor NK, their fibre and carbohydrate intake was suboptimal, whereas saturated fat intake exceeded recommendations. Many lacked awareness of current sports nutrition guidelines. Further nutrition education may be needed to improve diet quality and aid performance goals.

Dietary Intake of Adults Who Participate in CrossFit® Exercise Regimens

Background: The combination of high-intensity aerobic and high-load resistance training, as in CrossFit®, exerts similar or superior benefits to other exercise modalities. This study aimed to assess dietary habits and characterize the nutritional goals, exercise habits, and clinical health outcomes of individuals who participate in CrossFit®. Methods: Adults who are 19 y or older, with >6 mo of CrossFit® participation, completed an electronic survey and the dietary health questionnaire III. In separate models, multiple stepwise linear regressions were performed to detect the associations between (i) dietary intake, (ii) exercise habits, (iii) clinical measures, and a priori selected predictors (sex, weight status, age, and exercise frequency) in each case. Odds ratios were detected between nutritional and fitness goals, clinical outcomes, and predictors. Results: In total, 449 respondents completed both questionnaires. Of these, 443 respondents were used for relative macronutrients assessment due to not reporting body weight. Dietary intake was associated with sex, weight status, age, exercise frequency, and nutritional goals. Nutritional and fitness goals and clinical outcomes were associated with sex, weight status, age, and exercise frequency. Conclusion: Nutritional goals are underlying factors that affect eating behaviors in non-competitive CrossFit® participants. It is imperative to consider the sex, age, exercise habits, and nutritional goals of CrossFit® participants when investigating and prescribing dietary outcomes.

The functional and molecular effects of problematic alcohol consumption on skeletal muscle: a focus on athletic performance

Background: Chronic alcohol misuse is associated with alcoholic myopathy, characterized by skeletal muscle weakness and atrophy. Moreover, there is evidence that sports-related people seem to exhibit a greater prevalence of problematic alcohol consumption, especially binge drinking (BD), which might not cause alcoholic myopathy but can negatively impact muscle function and amateur and professional athletic performance.Objective: To review the literature concerning the effects of alcohol consumption on skeletal muscle function and structure that can affect muscle performance.Methodology: We examined the currently available literature (PubMed, Google Scholars) to develop a narrative review summarizing the knowledge about the effects of alcohol on skeletal muscle function and exercise performance, obtained from studies in human beings and animal models for problematic alcohol consumption.Results: Exercise- and sport-based studies indicate that alcohol consumption can negatively affect muscle recovery after vigorous exercise, especially in men, while women seem less affected. Clinical studies and pre-clinical laboratory research have led to the knowledge of some of the mechanisms involved in alcohol-related muscle dysfunction, including an imbalance between anabolic and catabolic pathways, reduced regeneration, increased inflammation and fibrosis, and deficiencies in energetic balance and mitochondrial function. These pathological features can appear not only under chronic alcohol misuse but also in other alcohol consumption patterns.Conclusions: Most laboratory-based studies use chronic or acute alcohol exposure, while episodic BD, the most common drinking pattern in amateur and professional athletes, is underrepresented. Nevertheless, alcohol consumption negatively affects skeletal muscle health through different mechanisms, which collectively might contribute to reduced sports performance.

The Effects of Dietary Protein Supplementation on Acute Changes in Muscle Protein Synthesis and Longer-Term Changes in Muscle Mass, Strength, and Aerobic Capacity in Response to Concurrent Resistance and Endurance Exercise in Healthy Adults: A Systematic Review

BACKGROUND

Engaging in both resistance and endurance exercise within the same training program, termed 'concurrent exercise training,' is common practice in many athletic disciplines that require a combination of strength and endurance and is recommended by a number of organizations to improve muscular and cardiovascular health and reduce the risk of chronic metabolic disease. Dietary protein ingestion supports skeletal muscle remodeling after exercise by stimulating the synthesis of muscle proteins and can optimize resistance exercise-training mediated increases in skeletal muscle size and strength; however, the effects of protein supplementation on acute and longer-term adaptive responses to concurrent resistance and endurance exercise are unclear.

OBJECTIVES

The purpose of this systematic review is to evaluate the effects of dietary protein supplementation on acute changes in muscle protein synthesis and longer-term changes in muscle mass, strength, and aerobic capacity in responses to concurrent resistance and endurance exercise in healthy adults.

METHODS

A systematic search was conducted in five databases: Scopus, Embase, Medline, PubMed, and Web of Science. Acute and longer-term controlled trials involving concurrent exercise and protein supplementation in healthy adults (ages 18-65 years) were included in this systematic review. Main outcomes of interest were changes in skeletal muscle protein synthesis rates, muscle mass, muscle strength, and whole-body aerobic capacity (i.e., maximal/peak aerobic capacity [VO_2max/peak]). The quality of studies was assessed using the National Institute of Health Quality Assessment for Controlled Intervention Studies.

RESULTS

Four acute studies including 84 trained young males and ten longer-term studies including 167 trained and 391 untrained participants fulfilled the eligibility criteria. All included acute studies demonstrated that protein ingestion enhanced myofibrillar protein synthesis rates, but not mitochondrial protein synthesis rates during post-exercise recovery after an acute bout of concurrent exercise. Of the included longer-term training studies, five out of nine reported that protein supplementation enhanced concurrent training-mediated increases in muscle mass, while five out of nine studies reported that protein supplementation enhanced concurrent training-mediated increases in muscle strength and/or power. In terms of aerobic adaptations, all six included studies reported no effect of protein supplementation on concurrent training-mediated increases in VO_2max/peak.

CONCLUSION

Protein ingestion after an acute bout of concurrent exercise further increases myofibrillar, but not mitochondrial, protein synthesis rates during post-exercise recovery. There is some evidence that protein supplementation during longer-term training further enhances concurrent training-mediated increases in skeletal muscle mass and strength/power, but not whole-body aerobic capacity (i.e., VO_2max/peak).

Nutritional Considerations for Injury Prevention and Recovery in Combat Sports

Sports participation is not without risk, and most athletes incur at least one injury throughout their careers. Combat sports are popular all around the world, and about one-third of their injuries result in more than 7 days of absence from competition or training. The most frequently injured body regions are the head and neck, followed by the upper and lower limbs, while the most common tissue types injured are superficial tissues and skin, followed by ligaments and joint capsules. Nutrition has significant implications for injury prevention and enhancement of the recovery process due to its effect on the overall physical and psychological well-being of the athlete and improving tissue healing. In particular, amino acid and protein intake, antioxidants, creatine, and omega-3 are given special attention due to their therapeutic roles in preventing muscle loss and anabolic resistance as well as promoting injury healing. The purpose of this review is to present the roles of various nutritional strategies in reducing the risk of injury and improving the treatment and rehabilitation process in combat sports. In this respect, nutritional considerations for muscle, joint, and bone injuries as well as sports-related concussions are presented. The injury risk associated with rapid weight loss is also discussed. Finally, preoperative nutrition and nutritional considerations for returning to a sport after rehabilitation are addressed.

Got Beer? A Systematic Review of Beer and Exercise

Beer is used to socialize postexercise, celebrate sport victory, and commiserate postdefeat. Rich in polyphenols, beer has antioxidant effects when consumed in moderation, but its alcohol content may confer some negative effects. Despite beer's popularity, no review has explored its effects on exercise performance, recovery, and adaptation. Thus, a systematic literature search of three databases (PubMed, SPORTDiscus, and Web of Science) was conducted by two reviewers. The search resulted in 16 studies that were appraised and reviewed. The mean PEDro score was 5.1. When individuals are looking to rehydrate postexercise, a low-alcohol beer (<4%) may be more effective. If choosing a beer higher in alcoholic content (>4%), it is advised to pair this with a nonalcoholic option to limit diuresis, particularly when relatively large volumes of fluid (>700 ml) are consumed. Adding Na+ to alcoholic beer may improve rehydration by decreasing fluid losses, but palatability may decrease. These conclusions are largely based on studies that standardized beverage volume, and the results may not apply equally to situations where people ingest fluids and food ad libitum. Ingesting nonalcoholic, polyphenol-rich beer could be an effective strategy for preventing respiratory infections during heavy training. If consumed in moderation, body composition and strength qualities seem largely unaffected by beer. Mixed results that limit sweeping conclusions are owed to variations in study design (i.e., hydration and exercise protocols). Future research should incorporate exercise protocols with higher ecological validity, recruit more women, prioritize chronic study designs, and use ad libitum fluid replacement protocols for more robust conclusions.

Resistance Exercise, Aging, Disuse, and Muscle Protein Metabolism

Skeletal muscle is the organ of locomotion, its optimal function is critical for athletic performance, and is also important for health due to its contribution to resting metabolic rate and as a site for glucose uptake and storage. Numerous endogenous and exogenous factors influence muscle mass. Much of what is currently known regarding muscle protein turnover is owed to the development and use of stable isotope tracers. Skeletal muscle mass is determined by the meal- and contraction-induced alterations of muscle protein synthesis and muscle protein breakdown. Increased loading as resistance training is the most potent nonpharmacological strategy by which skeletal muscle mass can be increased. Conversely, aging (sarcopenia) and muscle disuse lead to the development of anabolic resistance and contribute to the loss of skeletal muscle mass. Nascent omics-based technologies have significantly improved our understanding surrounding the regulation of skeletal muscle mass at the gene, transcript, and protein levels. Despite significant advances surrounding the mechanistic intricacies that underpin changes in skeletal muscle mass, these processes are complex, and more work is certainly needed. In this article, we provide an overview of the importance of skeletal muscle, describe the influence that resistance training, aging, and disuse exert on muscle protein turnover and the molecular regulatory processes that contribute to changes in muscle protein abundance. © 2021 American Physiological Society. Compr Physiol 11:2249-2278, 2021.

Aerobic exercise intensity does not affect the anabolic signaling following resistance exercise in endurance athletes

This study examined whether intensity of endurance stimulus within a concurrent training paradigm influenced the phosphorylation of signaling proteins associated with the mTOR and AMPK networks. Eight male cyclists completed (1) resistance exercise (RES), 6 × 8 squats at 80% 1-RM; (2) resistance exercise and moderate intensity cycling of 40 min at 65% V̇O_2peak, (RES + MIC); (3) resistance exercise and high intensity interval cycling of 40 min with 6 alternating 3 min intervals of 85 and 45% V̇O_2peak (RES + HIIC), in a cross-over design. Muscle biopsies were collected at rest and 3 h post-RES. There was a main effect of condition for mTOR^S2448 (p = 0.043), with a greater response in the RES + MIC relative to RES condition (p = 0.033). There was a main effect of condition for AMPKα2^T172 (p = 0.041), with a greater response in RES + MIC, relative to both RES + HIIC (p = 0.026) and RES (p = 0.046). There were no other condition effects for the remaining protein kinases assessed (p > 0.05). These data do not support a molecular interference effect in cyclists under controlled conditions. There was no intensity-dependent regulation of AMPK, nor differential activation of anabolism with the manipulation of endurance exercise intensity.

Considerations for Maximizing the Exercise "Drug" to Combat Insulin Resistance: Role of Nutrition, Sleep, and Alcohol

Insulin resistance is a key etiological factor in promoting not only type 2 diabetes mellitus but also cardiovascular disease (CVD). Exercise is a first-line therapy for combating chronic disease by improving insulin action through, in part, reducing hepatic glucose production and lipolysis as well as increasing skeletal muscle glucose uptake and vasodilation. Just like a pharmaceutical agent, exercise can be viewed as a "drug" such that identifying an optimal prescription requires a determination of mode, intensity, and timing as well as consideration of how much exercise is done relative to sitting for prolonged periods (e.g., desk job at work). Furthermore, proximal nutrition (nutrient timing, carbohydrate intake, etc.), sleep (or lack thereof), as well as alcohol consumption are likely important considerations for enhancing adaptations to exercise. Thus, identifying the maximal exercise "drug" for reducing insulin resistance will require a multi-health behavior approach to optimize type 2 diabetes and CVD care.

Post-exercise recovery for the endurance athlete with type 1 diabetes: a consensus statement

There has been substantial progress in the knowledge of exercise and type 1 diabetes, with the development of guidelines for optimal glucose management. In addition, an increasing number of people living with type 1 diabetes are pushing their physical limits to compete at the highest level of sport. However, the post-exercise recovery routine, particularly with a focus on sporting performance, has received little attention within the scientific literature, with most of the focus being placed on insulin or nutritional adaptations to manage glycaemia before and during the exercise bout. The post-exercise recovery period presents an opportunity for maximising training adaption and recovery, and the clinical management of glycaemia through the rest of the day and overnight. The absence of clear guidance for the post-exercise period means that people with type 1 diabetes should either develop their own recovery strategies on the basis of individual trial and error, or adhere to guidelines that have been developed for people without diabetes. This Review provides an up-to-date consensus on post-exercise recovery and glucose management for individuals living with type 1 diabetes. We aim to: (1) outline the principles and time course of post-exercise recovery, highlighting the implications and challenges for endurance athletes living with type 1 diabetes; (2) provide an overview of potential strategies for post-exercise recovery that could be used by athletes with type 1 diabetes to optimise recovery and adaptation, alongside improved glycaemic monitoring and management; and (3) highlight the potential for technology to ease the burden of managing glycaemia in the post-exercise recovery period.

Cannabidiol Does Not Impair Anabolic Signaling Following Eccentric Contractions in Rats

Cannabidiol (CBD) has proven clinical benefits in the treatment of seizures, inflammation, and pain. The recent legalization of CBD in many countries has caused increased interest in the drug as an over-the-counter treatment for athletes looking to improve recovery. However, no data on the effects of CBD on the adaptive response to exercise in muscle are available. To address this gap, we eccentrically loaded the tibialis anterior muscle of 14 rats, injected them with a vehicle (n = 7) or 100 mg/kg CBD (n = 7), and measured markers of injury, inflammation, anabolic signaling, and autophagy 18 hr later. Pro-inflammatory signaling through nuclear factor kappa B (NF-kB) (Ser536) increased with loading in both groups; however, the effect was significantly greater (36%) in the vehicle group (p < .05). Simultaneously, anabolic signaling through ribosomal protein S6 kinase beta-1 (S6K1) (Thr389) increased after eccentric contractions in both groups with no difference between vehicle and CBD (p = .66). The ribosomal protein S6 phosphorylation (240/244) increased with stimulation (p < .001) and tended to be higher in the CBD group (p = .09). The ubiquitin-binding protein p62 levels were not modulated by stimulation (p = .6), but they were 46% greater in the CBD compared with the vehicle group (p = .01). Although liver weight did not differ between the groups (p = .99) and levels of proteins associated with stress were similar, we did observe serious side effects in one animal. In conclusion, an acute dose of CBD decreased pro-inflammatory signaling in the tibialis anterior without blunting the anabolic response to exercise in rats. Future research should determine whether these effects translate to improved recovery without altering adaptation in humans.

Alcohol Intake Is Associated With Elevated Serum Levels of Selenium and Selenoprotein P in Humans

Selenoprotein P is a hepatokine with antioxidative properties that eliminate a physiologic burst of reactive oxygen species required for intracellular signal transduction. Serum levels of selenoprotein P are elevated during aging and in people with type 2 diabetes, non-alcoholic fatty liver disease, and hepatitis C. However, how serum levels of full-length selenoprotein P are regulated largely remains unknown, especially in the general population. To understand the significance of serum selenoprotein P levels in the general population, we evaluated intrinsic and environmental factors associated with serum levels of full-length selenoprotein P in 1,183 subjects participating in the Shika-health checkup cohort. Serum levels of selenium were positively correlated with liver enzymes and alcohol intake and negatively correlated with body mass index. Serum levels of selenoprotein P were positively correlated with age, liver enzymes, and alcohol intake. In multiple regression analyses, alcohol intake was positively correlated with serum levels of both selenium and selenoprotein P independently of age, gender, liver enzymes, and fatty liver on ultrasonography. In conclusion, alcohol intake is associated with elevated serum levels of selenium and selenoprotein P independently of liver enzyme levels and liver fat in the general population. Moderate alcohol intake may exert beneficial or harmful effects on health, at least partly by upregulating selenoprotein P. These findings increase our understanding of alcohol-mediated redox regulation and form the basis for the adoption of appropriate drinking guidelines.

Nutritional Considerations and Strategies to Facilitate Injury Recovery and Rehabilitation

Nutritional interventions are not commonly a standard of care in rehabilitation interventions. A nutritional approach has the potential to be a low-cost, high-volume strategy that complements the existing standard of care. In this commentary, our aim is to provide an evidence-based, practical guide for athletes with injuries treated surgically or conservatively, along with healing and rehabilitation considerations. Injuries are a normal and expected part of exercise participation. Regardless of severity, an injury typically results in the athlete's short- or long-term removal from participation. Nutritional interventions may augment the recovery process and support optimal healing; therefore, incorporating nutritional strategies is important at each stage of the healing process. Preoperative nutrition and nutritional demands during rehabilitation are key factors to consider. The physiological response to wounds, immobilization, and traumatic brain injuries may be improved by optimizing macronutrient composition, caloric consumption, and nutrient timing and using select dietary supplements. Previous research supports practical nutrition recommendations to reduce surgical complications, minimize deficits after immobilization, and maximize the chance of safe return to play. These recommendations include identifying the individual's caloric requirements to ensure that energy needs are being met. A higher protein intake, with special attention to evenly distributed consumption throughout the day, will help to minimize loss of muscle and strength during immobilization. Dietary-supplement strategies may be useful when navigating the challenges of appropriate caloric intake and timing and a reduced appetite. The rehabilitation process also requires a strong nutritional plan to enhance recovery from injury. Athletic trainers, physical therapists, and other health care professionals should provide basic nutritional recommendations during rehabilitation, discuss the timing of meals with respect to therapy, and refer the patient to a registered dietitian if warranted. Because nutrition plays an essential role in injury recovery and rehabilitation, nutritional interventions should become a component of standard-of-care practice after injury. In this article, we address best practices for implementing nutritional strategies among patients with athletic injuries.

Inside the Belly of a Beast: Individualizing Nutrition for Young, Professional Male Rugby League Players: A Review

Professional rugby league (RL) football is a contact sport involving repeated collisions and high-intensity efforts; both training and competition involve high energy expenditure. The present review summarizes and critiques the available literature relating the physiological demands of RL to nutritional requirements and considers potential ergogenic supplements that could improve players' physical capacity, health, and recovery during the preparatory and competition phases of a season. Although there may not be enough data to provide RL-specific recommendations, the available data suggest that players may require approximately 6-8 g·kg-1·day-1 carbohydrate, 1.6-2.6 g·kg-1·day-1 protein, and 0.7-2.2 g·kg-1·day-1 fat, provided that the latter also falls within 20-35% of total energy intake. Competition nutrition should maximize glycogen availability by consuming 1-4 g/kg carbohydrate (∼80-320 g) plus 0.25 g/kg (∼20-30 g) protein, 1-4 hr preexercise for 80-120 kg players. Carbohydrate intakes of approximately 80-180 g (1.0-1.5 g/kg) plus 20-67 g protein (0.25-0.55 g/kg) 0-2 hr postexercise will optimize glycogen resynthesis and muscle protein synthesis. Supplements that potentially improve performance, recovery, and adaptation include low to moderate dosages of caffeine (3-6 mg/kg) and ∼300 mg polyphenols consumed ∼1 hr preexercise, creatine monohydrate "loading" (0.3 g·kg-1·day-1) and/or maintenance (3-5 g/day), and beta-alanine (65-80 mg·kg-1·day-1). Future research should quantify energy expenditures in young, professional male RL players before constructing recommendations.

UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research

Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.

Role of sports psychology and sports nutrition in return to play from musculoskeletal injuries in professional soccer: an interdisciplinary approach

Musculoskeletal injuries are prevalent in professional soccer and can result in lost training time or match play. It is intuitive that the "return to play" (RTP) pathway will depend, in large part, on the expertise of sports medicine practitioners (e.g. surgeons, physicians, physiotherapists) responsible for player's recovery. Consensus statements on returning athletes to sport following injury acknowledge the contributions of sport psychology and sports nutrition. However, specific consideration on how to integrate these two recognized - but often overlooked components of injury rehabilitation - into existing sport medicine approaches has yet to be examined. Using a framework of milestones directed by the medical physician and physical trainer, the evidence is summarized and suggestions provided on the integration of sports psychology and sports nutrition into an interdisciplinary RTP approach. We examine recovery from a phase approach (acute injury and functional recovery) to highlight interdisciplinary opportunities in the management of musculoskeletal soccer injuries. An interdisciplinary approach is understood to achieve outcomes that could not be achieved within the framework of a single discipline. The incorporation of sports psychology and nutrition theoretically compliment milestones used in current medically-based RTP models. Our hope is that this article serves as a catalyst for interdisciplinary practice and research - not only in sports nutrition and sports psychology - but across all sport and exercise disciplines.

Sex differences in factors associated with poor subjective sleep quality in athletes

BACKGROUND

Sleep is an important recovery period for athletes. In general, women are not satisfied with their sleep quality, which is also true for female soccer players, although the reasons remain to be elucidated. This study aimed to confirm sex difference in sleep quality among athletes from various fields of sport, and to investigate factors related to poor subjective sleep quality in male and female athletes.

METHODS

We collected data concerning subjective sleep quality, measured by Pittsburgh Sleep Quality Index (PSQI), from athletes who were 16 to 40 years of age and played various types of sports. Data concerning their sports, lifestyle, and sleep issues and sleep environments, and also menstrual issues for females, were collected.

RESULTS

Data from 207 male athletes and 215 female athletes were assessed. Among them, 31.4% of men and 48.8% of women had poor subjective sleep quality (i.e., PSQI≥6). In male athletes, witnessed apnea, episodes of disorientation or confusion during the time of sleep, long time gap between dinner and bedtime, and turning on the heating in the winter, were identified as factors associated with poor sleep quality by multivariate analysis, whereas in female athletes, bathing close to bedtime, habitual drinking, and being annoyed by noises at bedtime were identified.

CONCLUSIONS

In both populations, females had poorer subjective sleep quality than males. Sex differences exist in factors associated with poor subjective sleep quality. Thus, different approaches should be considered to improve their sleep quality.

Risks associated with alcohol and marijuana use among college student athletes: The case for involving athletic personnel in prevention and intervention

The purpose of this study was to describe alcohol and marijuana use patterns and related consequences among student athletes. A total of 12,510 students (n=1,233 athletes) completed four cross-sectional online annual surveys as part of a multi-site campus initiative. Chi-square tests of independence, t-tests, and regression models evaluated differences in alcohol and marijuana use between athletes and non-athletes. The prevalence of binge drinking and high intensity drinking was significantly higher among student athletes than non-athletes, even after controlling for demographic characteristics. Thirteen percent of student athletes experienced an alcohol-related injury during the past year; this was more common among binge drinkers than non-binge drinkers (20.5% and 2.6%, respectively). Among student athletes, past-month binge drinking and past-year marijuana use were significantly associated with lowered GPA (ps<.01). Skipping class was twice as prevalent among student athletes who used marijuana as compared with athletes who did not use marijuana, but no differences were found related to binge drinking. Components for a training for athletic personnel to reduce risks for alcohol-related injury and academic consequences that are associated with alcohol and marijuana use among student athletes are described. Involving athletic personnel might be an important strategy to identify and intervene with high-risk student athletes.

Calorie-Containing Recovery Drinks Increase Recreational Runners' Voluntary Energy and Carbohydrate Intake, with Minimal Impact on Fluid Recovery

This study assessed voluntary dietary intake when different beverages were provided within a recovery area following recreational exercise. Participants completed two 10-km runs 1 week apart. Immediately after the first run, "beer drinkers" (n = 54; mean ± SD: age = 23.9 ± 5.8 years, body mass [BM] = 76 ± 13 kg) randomly received low-alcohol beer (Hahn Ultra^® [Lion Co.], 0.9% alcohol by volume) or sports drink (SD; Gatorade^® [PepsiCo]), whereas "nonbeer drinkers" (n = 78; age = 21.8 ± 2.2 years, BM = 71 ± 13 kg) received water or SD. Participants remained in a recovery area for 30-60 min with fluid consumption monitored. The following week, participants received the alternate beverage. Participants recorded all food/fluid consumed for the remainder of both trial days (diary and photographs). Fluid balance was assessed via BM change and urine specific gravity. Paired t tests were used to assess differences in hydration and dietary variables. No differences were observed in preexercise urine specific gravity (∼1.01) or BM loss (∼2%) between intervention groups (ps > .05). Water versus SD: No difference in acute fluid intake was noted (water = 751 ± 259 ml, SD = 805 ± 308 ml, p = .157). SD availability influenced total energy and carbohydrate intakes (water = 5.7 ± 2.5 MJ and 151 ± 77 g, SD = 6.5 ± 2.7 MJ and 187 ± 87 g, energy p = .002, carbohydrate p < .001). SD versus beer: SD availability resulted in greater acute fluid intake (SD = 1,047 ± 393 ml, beer = 850 ± 630 ml; p = .004), which remained evident at the end of trial days (SD = 3,337 ± 1,100 ml, beer = 2,982 ± 1,191 ml; p < .01). No differences in dietary variables were observed. Next day, urine specific gravity values were not different between water versus SD. However, a small difference was detected between SD versus beer (SD = 1.021 ± 0.009, beer = 1.016 ± 0.008, p = .002). Consuming calorie-containing drinks postexercise appears to increase daily energy and carbohydrate intake but has minimal impact on next-day hydration.

The Effects of Alcohol Consumption on Recovery Following Resistance Exercise: A Systematic Review

BACKGROUND

The aim of this manuscript was to describe the effects of alcohol ingestion on recovery following resistance exercise.

METHODS

A literature search was performed using the following database: Web of Science, NLM Pubmed, and Scopus. Studies regarding alcohol consumption after resistance exercise evaluating recovery were considered for investigation. The main outcomes took into account biological, physical and cognitive measures. Multiple trained researchers independently screened eligible studies according to the eligibility criteria, extracted data and assessed risk of bias.

RESULTS

A total of 12 studies were considered eligible and included in the quantitative synthesis: 10 included at least one measure of biological function, 10 included at least one measure of physical function and one included measures of cognitive function.

CONCLUSIONS

Alcohol consumption following resistance exercise doesn't seem to be a modulating factor for creatine kinase, heart rate, lactate, blood glucose, estradiol, sexual hormone binding globulin, leukocytes and cytokines, C-reactive protein and calcium. Force, power, muscular endurance, soreness and rate of perceived exertion are also unmodified following alcohol consumption during recovery. Cortisol levels seemed to be increased while testosterone, plasma amino acids, and rates of muscle protein synthesis decreased.

Effectiveness of whey protein supplements on the serum levels of amino acid, creatinine kinase and myoglobin of athletes: a systematic review and meta-analysis

BACKGROUND

Consuming whey protein supplements, along with physiotherapy and psychotherapy, have been recognised in sports performance. Whey protein supplements (WPS) is one of the commonly used supplements as ergogenic aids for athletes to enhance their muscle performance and recovery during sport-related injuries. The purpose of this systematic review is to investigate the effectiveness of WPS over the blood biochemistry mainly amino acids, creatinine kinase and myoglobin which influence performance and recovery among athletes.

METHOD

A comprehensive literature search was conducted to identify randomised control trials (RCTs) and non-RCTs that investigated the effectiveness of WPS on amino acids, creatinine kinase and myoglobin among athletes. Risk of Bias in Non-Randomised Studies of Interventions tool (ROBINS-I) and Cochrane Risk of Bias Assessment tool were used to rule out the quality of studies. Meta-analysis was performed using a random effect model with STATA version 14.2. The weighted mean difference was used to estimate the effectiveness of WPS against other supplements.

RESULTS

A total of 333,257 research articles were identified; of these, 15 records were included to proceed with the analysis. Meta-analysis has shown that WPS has significantly overall increased the level of essential amino acids level by 624.03 nmol/L (CI = 169.27, 1078.8; I² = 100%; p = 0.00) and branched-chain amino acids level by 458.57 nmol/L (CI = 179.96, 737.18; I² = 100%; p = 0.00) compared to the control group (without WPS). Moreover, was observed to decrease myoglobin level by 11.74 ng/ml (CI = - 30.24, 6.76; I² = 79.6%; p = 0.007) and creatine kinase level by 47.05 U/L (CI = - 129.47, 35.37; I² = 98.4%; p = 0.000) compared to the control group.

CONCLUSION

The findings revealed that the clinical evidence supports the effectiveness of WPS as a positive ergogenic aid on athletes' amino acids, creatinine kinase and myoglobin.

Beer or Ethanol Effects on the Body Composition Response to High-Intensity Interval Training. The BEER-HIIT Study

High-intensity interval training (HIIT) is promoted as a time-efficient strategy to improve body composition but concomitant beer intake, which is common among physically active individuals, may interfere with these effects. The primary aim of this study is to determine the effects of a 10-week (2 days/week) HIIT program on anthropometric and body composition measurements, and to assess whether those effects are influenced by the moderate consumption of beer (at least 5 days/week), or its alcohol equivalent. Young (24 ± 6 years old) healthy adults (n = 72, 35 females) volunteered for a non-training group (Non-Training group) or for HIIT training. Those going for training choose whether they preferred to receive alcohol or not. Those choosing alcohol were randomly allocated for receiving beer (5.4%; T-Beer group) or the equivalent amount of alcohol (vodka; T-Ethanol group) in sparkling water. Those choosing no-alcohol were randomly allocated for receiving alcohol-free beer (0.0%; T-0.0Beer group) or sparkling water (T-Water group). From Monday through Friday, men ingested 330 mL of the beverage with lunch and 330 mL with dinner; women ingested 330 mL with dinner. Before and after the intervention, anthropometry and body composition, through dual-emission X-ray absorptiometry, were measured. No changes in body mass, waist circumference, waist/hip ratio, visceral adipose tissue or bone mineral density occurred in any of the groups. By contrast, in all the training groups, significant decreases in fat mass together with increases in lean mass (all p < 0.05) occurred. These positive effects were not influenced by the regular intake of beer or alcohol. In conclusion, a moderate beer intake does not blunt the positive effect of 10-week HIIT on body composition in young healthy adults.

A single bout of strenuous exercise overcomes lipid-induced anabolic resistance to protein ingestion in overweight, middle-aged men

High-circulating lipid availability attenuates protein feeding-induced muscle protein synthesis (MPS). Whether the combined effects of exercise and protein ingestion can rescue this inhibition is unknown. In a parallel-groups design, middle-aged sedentary males (n = 28) matched for fat-free mass and body mass index received a 5-h intravenous infusion of either saline/control (n = 9), 20% intralipid infusion (n = 9), or intralipid with concomitant exercise (n = 10). Two hours into each of these infusions, participants received a primed constant infusion of L-(ring-[¹³C]₆)-phenylalanine. Muscle biopsies were taken immediately after control and lipid infusions, at which time, a 30-g protein beverage was ingested. Further biopsies were taken 2 and 4 h after protein ingestion. Intralipid increased plasma free fatty acid concentrations from ∼0.4-2 mM, resulting in an attenuated MPS response to protein ingestion, which was prevented by exercise. Intralipid resulted in a lower peak aminoacidemia following protein ingestion that was exacerbated by prior exercise, suggesting efficiency of the working skeletal muscle to utilize amino acid substrate to drive the postprandial anabolic response. We conclude that in the face of high-fat availability, exercise preserves the sensitivity of skeletal muscle to the anabolic properties of amino acids.-Smiles, W. J., Churchward-Venne, T. A., van Loon, L. J. C., Hawley, J. A., Camera, D. M. A single bout of strenuous exercise overcomes lipid-induced anabolic resistance to protein ingestion in overweight, middle-aged men.

Selected In-Season Nutritional Strategies to Enhance Recovery for Team Sport Athletes: A Practical Overview

Team sport athletes face a variety of nutritional challenges related to recovery during the competitive season. The purpose of this article is to review nutrition strategies related to muscle regeneration, glycogen restoration, fatigue, physical and immune health, and preparation for subsequent training bouts and competitions. Given the limited opportunities to recover between training bouts and games throughout the competitive season, athletes must be deliberate in their recovery strategy. Foundational components of recovery related to protein, carbohydrates, and fluid have been extensively reviewed and accepted. Micronutrients and supplements that may be efficacious for promoting recovery include vitamin D, omega-3 polyunsaturated fatty acids, creatine, collagen/vitamin C, and antioxidants. Curcumin and bromelain may also provide a recovery benefit during the competitive season but future research is warranted prior to incorporating supplemental dosages into the athlete's diet. Air travel poses nutritional challenges related to nutrient timing and quality. Incorporating strategies to consume efficacious micronutrients and ingredients is necessary to support athlete recovery in season.

Alcohol reduces muscle fatigue through atomistic interactions with nicotinic receptors

Alcohol consumption affects many organs and tissues, including skeletal muscle. However, the molecular mechanism of ethanol action on skeletal muscle remains unclear. Here, using molecular dynamics simulations and single channel recordings, we show that ethanol interacts with a negatively charged amino acid within an extracellular region of the neuromuscular nicotinic acetylcholine receptor (nAChR), thereby altering its global conformation and reducing the single channel current amplitude. Charge reversal of the negatively charged amino acid abolishes the nAChR-ethanol interaction. Moreover, using transgenic animals harboring the charge-reversal mutation, ex vivo measurements of muscle force production show that ethanol counters fatigue in wild type but not homozygous αE83K mutant animals. In accord, in vivo studies of motor coordination following ethanol administration reveal an approximately twofold improvement for wild type compared to homozygous mutant animals. Together, the converging results from molecular to animal studies suggest that ethanol counters muscle fatigue through its interaction with neuromuscular nAChRs.

Dietary Protein and Muscle in Aging People: The Potential Role of the Gut Microbiome

Muscle mass, strength, and physical function are known to decline with age. This is associated with the development of geriatric syndromes including sarcopenia and frailty. Dietary protein is essential for skeletal muscle function. Resistance exercise appears to be the most beneficial form of physical activity for preserving skeletal muscle and a synergistic effect has been noted when this is combined with dietary protein. However, older adults have shown evidence of anabolic resistance, where greater amounts of protein are required to stimulate muscle protein synthesis, and response is variable. Thus, the recommended daily amount of protein is greater for older people. The aetiologies and mechanisms responsible for anabolic resistance are not fully understood. The gut microbiota is implicated in many of the postulated mechanisms for anabolic resistance, either directly or indirectly. The gut microbiota change with age, and are influenced by dietary protein. Research also implies a role for the gut microbiome in skeletal muscle function. This leads to the hypothesis that the gut microbiome might modulate individual response to protein in the diet. We summarise the existing evidence for the role of the gut microbiota in anabolic resistance and skeletal muscle in aging people, and introduce the metabolome as a tool to probe this relationship in the future.

The guardian of the genome p53 regulates exercise-induced mitochondrial plasticity beyond organelle biogenesis

The Guardian of the Genome p53 has been established as a potent tumour suppressor. However, culminating from seminal findings in rodents more than a decade ago, several studies have demonstrated that p53 is required to maintain basal mitochondrial function [ie, respiration and reactive oxygen species (ROS) homeostasis]. Specifically, via its role(s) as a tumour suppressor, p53 intimately surveys cellular DNA damage, in particular mitochondrial DNA (mtDNA), to ensure that the mitochondrial network is carefully monitored and cell viability is upheld, because aberrant mtDNA damage leads to apoptosis and widespread cellular perturbations. Indeed, data from rodents and humans have demonstrated that p53 forms an integral component of the exercise-induced signal transduction network regulating skeletal muscle mitochondrial remodelling. In response to exercise-induced disruptions to cellular homeostasis that have the potential to harm mtDNA (eg, contraction-stimulated ROS emissions), appropriate p53-regulated, mitochondrial turnover responses prevail to protect the genome and ultimately facilitate a shift from aerobic glycolysis to oxidative phosphorylation, adaptations critical for endurance-based exercise that are commensurate with p53's role as a tumour suppressor. Despite these observations, several discrepancies exist between rodent and human studies pinpointing p53 subcellular trafficking from nuclear-to-mitochondrial compartments following acute exercise. Such interspecies differences in p53 activity and the plausible p53-mediated adaptations to chronic exercise training will be discussed herein.

Fueling for Performance

Context:

Proper nutrition is crucial for an athlete to optimize his or her performance for training and competition. Athletes should be able to meet their dietary needs through eating a wide variety of whole food sources.

Evidence Acquisition:

PubMed was searched for relevant articles published from 1980 to 2016.

Study Design:

Clinical review.

Level of Evidence:

Level 4.

Results:

An athlete should have both daily and activity-specific goals for obtaining the fuel necessary for successful training. Depending on the timing of their season, athletes may be either trying to gain lean muscle mass, lose fat, or maintain their current weight.

Conclusion:

An athlete will have different macronutrient goals depending on sport, timing of exercise, and season status. There are no specific athletic micronutrient guidelines, but testing should be considered for athletes with deficiency or injury. Also, some athletes who eliminate certain whole food groups (eg, vegetarian) may need to supplement their diet to avoid deficiencies.

Practical nutritional recovery strategies for elite soccer players when limited time separates repeated matches

Specific guidelines that aim to facilitate the recovery of soccer players from the demands of training and a congested fixture schedule are lacking; especially in relation to evidence-based nutritional recommendations. The importance of repeated high level performance and injury avoidance while addressing the challenges of fixture scheduling, travel to away venues, and training commitments requires a strategic and practically feasible method of implementing specific nutritional strategies. Here we present evidence-based guidelines regarding nutritional recovery strategies within the context of soccer. An emphasis is placed on providing practically applicable guidelines for facilitation of recovery when multiple matches are played within a short period of time (i.e. 48 h). Following match-play, the restoration of liver and muscle glycogen stores (via consumption of ~1.2 g⋅kg⁻¹⋅h⁻¹ of carbohydrate) and augmentation of protein synthesis (via ~40 g of protein) should be prioritised in the first 20 min of recovery. Daily intakes of 6–10 g⋅kg⁻¹ body mass of carbohydrate are recommended when limited time separates repeated matches while daily protein intakes of >1.5 g⋅kg⁻¹ body mass should be targeted; possibly in the form of multiple smaller feedings (e.g., 6 × 20–40 g). At least 150% of the body mass lost during exercise should be consumed within 1 h and electrolytes added such that fluid losses are ameliorated. Strategic use of protein, leucine, creatine, polyphenols and omega-3 supplements could also offer practical means of enhancing post-match recovery.

Effect of Acute Alcohol Ingestion on Resistance Exercise-Induced mTORC1 Signaling in Human Muscle

Duplanty, AA, Budnar, RG, Luk, HY, Levitt, DE, Hill, DW, McFarlin, BK, Huggett, DB, and Vingren, JL. Effect of acute alcohol ingestion on resistance exercise-induced mTORC1 signaling in human muscle. J Strength Cond Res 31(1): 54-61, 2017-The purpose of this project was to further elucidate the effects postexercise alcohol ingestion. This project had many novel aspects including using a resistance exercise (RE) only exercise design and the inclusion of women. Ten resistance-trained males and 9 resistance-trained females completed 2 identical acute heavy RE trials (6 sets of Smith machine squats) followed by ingestion of either alcohol or placebo. All participants completed both conditions. Before exercise (PRE) and 3 (+3 hours) and 5 (+5 hours) hours postexercise, muscle tissue samples were obtained from the vastus lateralis by biopsies. Muscle samples were analyzed for phosphorylated mTOR, S6K1, and 4E-BP1. For men, there was a significant interaction effect for mTOR and S6K1 phosphorylation. At +3 hours, mTOR and S6K1 phosphorylation was higher for placebo than for alcohol. For women, there was a significant main effect for time. mTOR phosphorylation was higher at +3 hours than at PRE and at +5 hours. There were no significant effects found for 4E-BP1 phosphorylation in men or women. The major findings of this study was that although RE elicited similar mTORC1 signaling both in men and in women, alcohol ingestion seemed to only attenuate RE-induced phosphorylation of the mTORC1 signaling pathway in men. This study provides evidence that alcohol should not be ingested after RE as this ingestion could potentially hamper the desired muscular adaptations to RE by reducing anabolic signaling, at least in men.

The Impact of Shiftwork on Skeletal Muscle Health

(1) Background: About one in four workers undertake shift rosters that fall outside the traditional 7 a.m.-6 p.m. scheduling. Shiftwork alters workers' exposure to natural and artificial light, sleep patterns, and feeding patterns. When compared to the rest of the working population, shiftworkers are at a greater risk of developing metabolic impairments over time. One fundamental component of metabolic health is skeletal muscle, the largest organ in the body. However, cause-and-effect relationships between shiftwork and skeletal muscle health have not been established; (2) Methods: A critical review of the literature was completed using online databases and reference lists; (3) Results: We propose a conceptual model drawing relationships between typical shiftwork consequences; altered light exposure, sleep patterns, and food and beverage consumption, and drivers of skeletal muscle health-protein intake, resistance training, and hormone release. At present, there is no study investigating the direct effect of shiftwork on skeletal muscle health. Instead, research findings showing that acute consequences of shiftwork negatively influence skeletal muscle homeostasis support the validity of our model; (4) Conclusion: Further research is required to test the potential relationships identified in our review, particularly in shiftwork populations. Part of this testing could include skeletal muscle specific interventions such as targeted protein intake and/or resistance-training.

Energy intake and energy expenditure of pre-professional female contemporary dancers

Many athletes in aesthetic and weight dependent sports are at risk of energy imbalance. However little is known about the exercise and eating behaviours of highly trained dance populations. This investigation sought to determine the energy intake and energy expenditure of pre-professional female contemporary dancers. Twenty-five female contemporary dance students completed the study. Over a 7-day period, including five week days (with scheduled dance training at a conservatoire) and two weekend days (with no scheduled dance training at the conservatoire), energy intake (self-reported weighed food diary and 24 h dietary recall) and expenditure (tri-axial accelerometry) were recorded. Mean daily energy intake and expenditure were different over the 7-day period (P = 0.014) equating to an energy deficit of -356 ± 668 kcal·day-1 (or -1.5 ± 2.8 MJ·day-1). Energy expenditure was not different when comparing week and weekend days (P = 0.297). However daily energy intake (P = 0.002), energy availability (P = 0.003), and energy balance (P = 0.004) were lower during the week compared to the weekend, where energy balance became positive. The percentage contribution of macronutrients to total energy intake also differed; with higher fat (P = 0.022) and alcohol (P = 0.020), and lower carbohydrate (P = 0.001) and a trend for lower protein (P = 0.051) at the weekend. Energy balance and appropriate macronutrient intake are essential for maintaining the demands of training, performance and recovery. Whilst aesthetics are important, female contemporary dancers may be at risk of the numerous health and performance impairments associated with negative energy balance, particularly during periods of scheduled training.

American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance

It is the position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy of Nutrition and Dietetics, Dietitians of Canada (DC), and American College of Sports Medicine (ACSM), other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian/nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics (CSSD) is a registered dietitian/nutritionist and a credentialed sports nutrition expert.

Protein coingestion with alcohol following strenuous exercise attenuates alcohol-induced intramyocellular apoptosis and inhibition of autophagy

Alcohol ingestion decreases postexercise rates of muscle protein synthesis, but the mechanism(s) (e.g., increased protein breakdown) underlying this observation is unknown. Autophagy is an intracellular "recycling" system required for homeostatic substrate and organelle turnover; its dysregulation may provoke apoptosis and lead to muscle atrophy. We investigated the acute effects of alcohol ingestion on autophagic cell signaling responses to a bout of concurrent (combined resistance- and endurance-based) exercise. In a randomized crossover design, eight physically active males completed three experimental trials of concurrent exercise with either postexercise ingestion of alcohol and carbohydrate (12 ± 2 standard drinks; ALC-CHO), energy-matched alcohol and protein (ALC-PRO), or protein (PRO) only. Muscle biopsies were taken at rest and 2 and 8 h postexercise. Select autophagy-related gene (Atg) proteins decreased compared with rest with ALC-CHO (P < 0.05) but not ALC-PRO. There were parallel increases (P < 0.05) in p62 and PINK1 commensurate with a reduction in BNIP3 content, indicating a diminished capacity for mitochondria-specific autophagy (mitophagy) when alcohol and carbohydrate were coingested. DNA fragmentation increased in both alcohol conditions (P < 0.05); however, nuclear AIF accumulation preceded this apoptotic response with ALC-CHO only (P < 0.05). In contrast, increases in the nuclear content of p53, TFEB, and PGC-1α in ALC-PRO were accompanied by markers of mitochondrial biogenesis at the transcriptional (Tfam, SCO2, and NRF-1) and translational (COX-IV, ATPAF1, and VDAC1) level (P < 0.05). We conclude that alcohol ingestion following exercise triggers apoptosis, whereas the anabolic properties of protein coingestion may stimulate mitochondrial biogenesis to protect cellular homeostasis.

Nutritional Support for Exercise-Induced Injuries

Nutrition is one method to counter the negative impact of an exercise-induced injury. Deficiencies of energy, protein and other nutrients should be avoided. Claims for the effectiveness of many other nutrients following injuries are rampant, but the evidence is equivocal. The results of an exercise-induced injury may vary widely depending on the nature of the injury and severity. Injuries typically result in cessation, or at least a reduction, in participation in sport and decreased physical activity. Limb immobility may be necessary with some injuries, contributing to reduced activity and training. Following an injury, an inflammatory response is initiated and while excess inflammation may be harmful, given the importance of the inflammatory process for wound healing, attempting to drastically reduce inflammation may not be ideal for optimal recovery. Injuries severe enough for immobilization of a limb result in loss of muscle mass and reduced muscle strength and function. Loss of muscle results from reductions in basal muscle protein synthesis and the resistance of muscle to anabolic stimulation. Energy balance is critical. Higher protein intakes (2-2.5 g/kg/day) seem to be warranted during immobilization. At the very least, care should be taken not to reduce the absolute amount of protein intake when energy intake is reduced. There is promising, albeit preliminary, evidence for the use of omega-3 fatty acids and creatine to counter muscle loss and enhance hypertrophy, respectively. The overriding nutritional recommendation for injured exercisers should be to consume a well-balanced diet based on whole, minimally processed foods or ingredients made from whole foods. The diet composition should be carefully assessed and changes considered as the injury heals and activity patterns change.

Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance

It is the position of the Academy of Nutrition and Dietetics (Academy), Dietitians of Canada (DC), and the American College of Sports Medicine (ACSM) that the performance of, and recovery from, sporting activities are enhanced by well-chosen nutrition strategies. These organizations provide guidelines for the appropriate type, amount, and timing of intake of food, fluids, and supplements to promote optimal health and performance across different scenarios of training and competitive sport. This position paper was prepared for members of the Academy, DC, and ACSM, other professional associations, government agencies, industry, and the public. It outlines the Academy's, DC's, and ACSM's stance on nutrition factors that have been determined to influence athletic performance and emerging trends in the field of sports nutrition. Athletes should be referred to a registered dietitian nutritionist for a personalized nutrition plan. In the United States and in Canada, the Certified Specialist in Sports Dietetics is a registered dietitian nutritionist and a credentialed sports nutrition expert.